understand that no location is immune to someone having an overdose, including the funeral home property. If the death occurred from an overdose and law enforcement is trying to establish who was responsible for selling the opioids and the circumstances surrounding the death, it is not out of the ordinary for law enforcement to arrive at the visitation or funeral. Oftentimes, disguised as mourners, they video record the license plates of visitors in the parking lot and check the plates at the station. There have been reports of police officers taking photos of the register book to cross-check names. In both of these instances, it allows law enforcement officers to develop leads for an arrest.
Another issue could arise with individuals using or having an actual overdose in the funeral home or in the immediate area. As previously discussed, a friend attending a visitation honoring someone who has died of an overdose may inject an opioid substance in the funeral home bathroom or in the parking lot. For instance: during the visitation the funeral director is approached by a female mourner inquiring if there is another restroom that she can use, indicating that the women’s bathroom has been occupied for a significant amount of time. The funeral director knocks loudly on the bathroom door and receives no response. This should raise a red flag and should not be dismissed. It is important to
DANGERS TO FUNERAL DIRECTORS AND EMBALMERS
his friend who recently died of an overdose. As one last “hurrah,” the friend goes into the funeral home restroom or parking lot and uses some heroin and has a fallout (overdose). Coroners and medical examiners face the same issues as funeral directors and embalmers. Coroners and deputy coroners are often called to scenes of overdose victims. They arrive at a known location where drugs are used, and there is a strong possibility that active drug users will still be there. At that time, there is the potential that the drug user at the residence could overdose while the deputy coroner is there. Also, the coroner’s office can be contaminated by opioids while removing the clothing before the autopsy, affecting the coroner or medical examiner. Also, there is always the inadvertent stick of a syringe when removing the body from the residence. It is important to remember that opioid residue can remain on the skin, clothing, or on personal belongings of someone who died of an overdose. The residue can be absorbed through the tissue or inhaled and cause an overdose. body off the cot and place it on the embalming table. As far as the interior of the cot, with the proper personal protective equipment in place, someone needs to wipe down the inside with soap and water to remove any residual opioids to avoid an accidental exposure. It should be air dried before being put away. Before removing the clothing, it is important to apply water or a disinfectant from a spritz bottle or the mortuary water tube with low pressure on the contaminated clothing to keep the substances from becoming airborne, and carefully placing them in the medical waste container (Alabama Funeral Directors Association, 2017). Extreme caution should be used when removing the clothes. It is advisable to not reach in or around areas that cannot be seen so to avoid being inadvertently stuck with a syringe. A staff member should immediately rinse the body off with water and wash with a cloth accompanied by germicidal soap to remove any opioid residue and prevent the aerosolization of opioids (Alabama Funeral Directors Association, 2017). Considering Occupational Safety and Health Administration (OSHA) compliance directives, the funeral director should make sure that every funeral employee knows not only the location of the Safety Data Sheets (SDS) but also how to read and understand them, and to know how to look up the chemicals and hazards that are directly related to their occupation. (As of 2015, they are no longer called the Material Safety Data Sheets [MSDS]).
So why is the opioid overdose crisis so important to understand? How does it affect the death care industry and the medico/legal offices of the coroner or medical examiner? First, let us discuss how funeral directors and embalmers are affected. As discussed earlier, pills are often crushed and snorted for immediate relief, so many opioids can be turned into a powder form. These powders can become airborne while removing or disturbing clothing before embalming. The embalmer unknowingly breathes in the opioid and thus encounters direct contact with the dangerous drug (WESCO, 2019). Another example is removing patches from the deceased before embalming. Those patches contain fentanyl which is offered to the patient for pain relief during a hospital stay. By carelessly removing the patches, the embalmer can come into direct contact with fentanyl and have an accidental overdose. Lastly, and in the most extreme case, someone arrives at the funeral home for a visitation to pay his last respects to First call transfer It is imperative for funeral home staff to know the signs and symptoms of an overdose: ● Blue or purple lips. ● Pinpoint pupils. ● Pale, clammy skin. ● Infrequent breathing. If it is known that the death was an overdose from an opioid, it is encouraged to have two individuals for the transfer so they can observe each other in case of an accidental exposure (Alabama Funeral Directors Association, 2017). Certain items should be stored in the funeral transfer van before removal: N95 mask, nitrile gloves, and a naloxone kit. Caution should be taken when handling personal effects, as drug residue may contaminate cell phones, wallets, and purses (Alabama Funeral Directors Association, 2017). Unintentional contact can result in an overdose, so it is important to know the symptoms (Alabama Funeral Directors Association, 2017). When doing the transfer at the place of death, funeral home staff should be conscious to not disturb the clothing of the deceased. They should wrap the individual in the bed sheet that accompanied the funeral cot, securely wrapping and keeping all potential powders from becoming airborne (Alabama Funeral Directors Association, 2017). When arriving at the funeral home, staff should carefully move the ● Deep snoring or gurgling. ● A slow or no heart rate. (Illinois Department of Public Health, 2019)
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